For a long time, the likelihood of surviving pancreatic cancer has been extremely low. For patients who were diagnosed with metastatic pancreatic cancer between 2015 and 2021, about 97% died within five years of their diagnosis.
Author
- Christopher Lieu
Professor of Medical Oncology, University of Colorado Anschutz
Pancreatic cancer is so deadly in part because there are no effective screening tests, and it rarely causes noticeable symptoms in its earliest stages. By the time a patient experiences signs, such as jaundice - a yellowing of the skin - or abdominal pain, the cancer has often already spread to other organs.
As a gastrointestinal oncologist and researcher specializing in early-phase clinical trials, I have seen the critical need for more effective therapies for patients with pancreatic cancer. For decades, successfully targeting the central mechanism that causes the vast majority of pancreatic cancers was considered impossible.
However, that narrative is rapidly changing with a drug approved on Aug. 26, 2026 , that can shut down the key protein that drives pancreatic cancer, nearly doubling survival rates for patients with advanced stages of the disease.
'Undruggable' tumors
The standard treatment for advanced pancreatic cancer has historically relied on chemotherapy , potent drugs designed to kill rapidly dividing cells. While chemotherapy can slow the progression of the disease, its effectiveness is often limited by the ability of pancreatic cancer cells to develop resistance against these drugs .
Pancreatic cancer's success lies in its genetics. More than 90% of pancreatic tumors are driven by mutations in a gene called KRAS . This gene codes for proteins that function as switches that turn cell growth on and off. When the KRAS gene is mutated, the switch becomes permanently stuck in the "on" position, commanding cancer cells to multiply endlessly.
For decades, scientists considered KRAS to be "undruggable ." The surface of the protein is exceptionally smooth, lacking the molecular pockets that standard drugs require to bind to and turn the switch off.
Because existing drugs haven't been able to target this protein, treatment for pancreatic cancer has primarily relied on toxic drugs that act more like blunt instruments than precise tools. Chemotherapy attempts to control the disease through widespread cell destruction, causing significant collateral damage to healthy tissues that lead to side effects.
What is daraxonrasib?
A new drug called daraxonrasib offers a critical advance in treating metastatic pancreatic cancer.
Daraxonrasib is taken daily by mouth. Instead of binding to KRAS directly, it attaches to a molecule called cyclophilin A in cells that helps fold proteins into their final 3D structures. This protein complex is then able to bind to the active KRAS protein and shut down its ability to signal cancer cells to multiply.
The company developing the drug, Revolution Medicines, presented results on May 31, 2026, from its Phase 3 clinical trial of 500 patients with metastatic pancreatic cancer who had received prior treatment. Compared to standard chemotherapy, daraxonrasib nearly doubled overall survival from 6.7 months to 13.2 months after diagnosis. Overall, daraxonrasib reduced the risk of death for metastatic pancreatic cancer patients by 60%.
The most common side effect is a prominent skin rash , which affected more than 86% of patients in the study. Patients also frequently dealt with stomatitis - painful swelling and sores inside the mouth - as well as diarrhea, nausea and vomiting. However, patients taking daraxonrasib were far less likely to stop treatment due to severe side effects compared to chemotherapy, and they had improved quality of life with reduced pain.
Next steps for daraxonrasib
With the Food and Drug Administration's August 2026 approval of daraxonrasib , eligible patients will now be able to receive the drug to treat metastatic pancreatic cancer. The approval will provide much-needed, real-world data that may inform medical best practices and future research.
Moving forward, we expect to see an increase in clinical trials exploring combination therapies, pairing KRAS inhibitors such as daraxonrasib with other drugs to prevent tumors from developing resistance and to extend survival even further. In addition, there are numerous " next-generation" inhibitors in development that may be more effective while limiting toxic side effects.
Daraxonrasib's approval proves that precision medicine has entered a new era in the treatment of pancreatic cancer. This sets the stage for more personalized, targeted and effective drugs in the future that will provide hope for patients and their families who deserve the best care possible to treat and prevent this challenging disease.
This is an updated version of an article originally published on June 2, 2026 .
Christopher Lieu does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
